Coordination of STD and SSD Payments

By / January 13, 2017 / After You’re Approved for Social Security Disability & SSI / 38 Comments

Find out what happens when short-term disability (STD) payments overlap with Social Security Disability (SSD), and how long-term disability (LTD) factors in.

Dear Disability Advisor,

I looked up my status of social security disability claim and this is what it states: “Your claim for Disability benefits has been approved. A detailed notice has been sent to you with your benefit information. For more information please use the Benefit Verification Letter to check your benefit details.   If you disagree with the decision, you may request an appeal in 60 days of the date on the Notice of Decision you receive.” Does this mean my disability has been approved? I’ve been out of work since October 2016 and am receiving short term disability through my employer until April 1, 2017.  Will this effect my disability amount if I am in deed approved?  Thanks!!!

Tammy

Dear Tammy,

The status you received indicates that you will be receiving either a fully favorable or partially favorable decision. Partially favorable would mean  that either the established disability date is later than you claimed or there’s been a determination that you have recovered and your claim has been closed, making only back benefits payable.

Usually  short-term disability (STD) policies have a provision that requires recalculation of STD benefits for any months that you have been paid STD and for which you will be paid Social Security disability (SSD aka SSDI). This means that you will be required to use your SSD back benefits to repay the STD overpayment if there were any overlapping months.

If the STD is higher than ongoing SSD, you will continue to receive reduced STD to supplement the Social Security until the STD maximum benefit period runs out. The same is true of long-term disability (LTD) insurance if you have LTD coverage when STD ends. You can request a copy of your STD policy to review all the provisions.

Sincerely,
The Disability Advisor

Coordination of STD and SSD Payments
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  • Dear Tamana,

    The Appeals Council normally takes at least a year from the time you file your appeal until you actually receive a decision, but that is if everything goes smoothly. And it can take longer. The Appeals Council will be in contact with your attorney at a few stages of the process. For example, at some point, they will ask your attorney to submit any additional arguments and evidence he may have so that they can make sure they have everything necessary to make their decision. If your attorney asks for more time for some reason to submit his arguments or appeals, it may delay the process. You may want to talk to your attorney and ask them if they anticipate having to ask the Appeals Council for more time to submit anything they require. Also ask them if there is anything you can do to strengthen your claim at this point. There may however be little you can do other then try to get opinions from your doctors that relate back to the time period that your judge was originally considering for your disability.

    Sincerely,
    Disability Adviser

  • You are welcome, Tamana.

  • Hi Tamana,

    You should always discuss any information you want to submit with your attorney and probably let them do it so they have a copy of anything that goes into your file. You don’t want your attorney to be surprised by anything later on in the case. You will also want their input on the affect any evidence will have on your claim and if the rules even allow you to submit new evidence. They get paid for guiding you through a complicated legal system that they are experts in. Let them do their job and earn their money.

    Sincerely,
    Disability Adviser

  • You are welcome, Tamana.

  • Dear Tamana,

    I recommend that you request a copy of your claim file and consult with an attorney about how to prepare your appeal. When you hire a Social Security attorney, you do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount the attorney can charge and the Social Security Administration pays the attorney directly from your back pay. The only possible cost in case of an unsuccessful claim or appeal is possibly having to reimburse the attorney for his or her out-of-pocket costs, for example, amounts the attorney paid to obtain your medical records.

    Sincerely,
    Kay

  • Dear Ddb,

    Check with Social Security to be sure the attorney was not paid. Then if your back pay was as much as $24,000, you do owe the attorney $6,000. If it was less than $24,000, then you owe only 25% of the back pay. I am surprised that you would have spent $24,000 in less than a month, so perhaps you owe him less. If you don’t have the funds to pay him, you will have to set up a payment plan.

    Sincerely,
    Kay

  • You are welcome, Tamana.

  • Dear Tamana,

    I am not totally clear on what the situation is but I think you are saying that your response to the offer of a supplemental hearing needs to be sent in and then the judge will complete his decision and send the decision to letter writing. All decisions go to the letter writing department, which is usually in the same hearing office. The letter writing is usually only sent to another office when there is a very big back log and the office needs help.

    Sincerely,
    Kay

  • You are welcome, Tamana.

  • Dear Tamana,

    It means that you are being offered the opportunity to submit more evidence at a hearing if you would like.

    Sincerely,
    Kay

  • Dear Angelica,

    Even if you got a decision from the judge tomorrow it would likely be a couple of weeks to a month or more before you got the written decision and a month after that before you actually got money. So, I encourage you to contact all the social service organizations in your area who provide services to people who are homeless to see if they can provide any help with shelter. Be sure to tell them about your medical conditions and your pending appeal.

    Sincerely,
    Kay

  • You are welcome and do not worry about the double posting.

  • You are welcome, Tamana.

  • Dear Tamana,

    The judge will make the decision considering all the evidence including the report by the consulting physician and the written opinions of any physicians working at DDS.

    Sincerely,
    Kay

  • Dear Deborah,

    Please see my response of a few minutes ago to the first posting of your question.

    Sincerely,
    Kay

  • Dear Debrah,

    The judge is supposed to judge and use his judgment to decide a case; that is the nature of the job. All significant evidence is supposed to be considered and discussed in the decision; not doing so is an error, but I don’t know that there is any law it is against.

    Sincerely,
    Kay

  • You are welcome, Tamara.

  • Dear Tamana,

    Your question was answered a few minutes ago. (Generally allow forty-eight hours for reply.)

    Sincerely,
    Kay

  • Dear Tamana,

    I am not sure what a profit letter is unless you are self-employed and you are being asked to provide information about how much your business is profiting. If that is the case, the information is needed as part of the determination of whether you are disabled, specifically whether you are working and performing substantial gainful activity (SGA). (To be disabled you must be unable to perform SGA.) SGA for self-employment on new claims considers earnings, services, and hours worked. The SGA earnings level in 2017 is $1,170 gross wages or net self-employment per month.

    Sincerely,
    Kay

  • Dear Tamana,

    You have been waiting longer than average. I suggest that you call the hearing office to find out where your claim is in the post-hearing process. The call will not speed things up, but it will give you a bit of information.

    Sincerely,
    Kay

  • Dear Tamana,

    Sometimes a vocational or medical consultant will “attend” a hearing via telephone. (Full hearings are sometimes even done with everyone on video conferencing.)

    Sincerely,
    Kay

    • Tamana

      Ok Thank You Kay for taking time out To answer my questions

  • Dear Tamana,

    The judge will make the decision on your medical eligibility for Supplemental Security Income (SSI).

    Sincerely,
    Kay

  • Andrea

    Hi,I had my hearing on Feb 21st still no word is that good or bad?

    • Dear Andrea,

      You appear to have posted your question twice. Please see my response to your first question.

      Thank you,
      Kay

  • Dear Dave,

    Let me try to explain again. You are already eligible for more than twenty-four months of Social Security Disability (SSDI) benefits. Your claim is being processed and you will eventually get the SSDI back pay for all those months (reduced by SSI paid for any of the same months). Because of your eligibility for past months, you are automatically eligible for Medicare in the twenty-fifth month of SSDI eligibility.

    As I explained in my prior response, you can refuse Part B Medicare, but there are consequences for doing so. Also, the state may not be willing to or legally able to reinstate your state health insurance coverage because you refused Medicare and/or because your SSDI may be too high for coverage.

    Sincerely,
    Kay

  • Dave s

    I got a letter from social security saying that they are withholding my back benefits and they are taking out medicare premiums out of my back pay, I did not have disability or medicare before so how can they collect premiums for something I did not have, I understand them holding the back pay, but I don’t understand them taking out premiums

    • Dear Dave,

      You are eligible for Medicare beginning with the twenty-fifth month of disability. Part B Medicare, which covers doctors and most out-patient services requires payment of a premium. You can refuse the Medicare coverage and you will not have to pay premiums for past months; however, if you want Medicare now, you would not be able to get it. You would have to wait until the next general enrollment period, which is in the last quarter of the year and your insurance would not begin until the following July. In addition, your premiums would be higher than if you had accepted enrollment at the first point you were eligible. Note that if you had medical services in past months and your Medicare starts for those months, the unpaid bills or your proof of paying for the medical services can be sent to Medicare for payment to the provider or reimbursement to you.

      Sincerely,
      Kay

    • Dear Dave,

      Medicare entitlement starts with the twenty-fifth month of disability benefits including past months. Accordingly, premiums are withheld. If you have any unpaid medical bills from those months, you can ask the medical providers to submit them to Medicare for payment or for credit toward the annual Medicare deductible. If you paid medical bills for months your were covered by Medicare, you can submit the bill and proof of payment and submit them for reimbursement or application to the deductible.

      Sincerely,
      Kay

  • Dear Dee,

    You are eligible for SSDI while getting SDI, but the SSDI will be offset (reduced) by the SDI and if the SDI is equal to or more than the SSDI, then the offset would be total and no SSDI would be payable until SDI stops. The offset will apply to any back pay months for which you were also eligible for SDI, so it is likely that no back pay will be payable.

    Sincerely,
    Kay

  • Dear Ashley,

    If you are approved, Supplemental Security Income (SSI) will, as its name implies, supplement (add to) your Social Security Disability (SSD) benefit; it will not duplicate it. So, with $330 Social Security, the maximum SSI you could receive is $425. If you are getting free housing from a relative or friend, the amount would be less.

    Sincerely,
    Kay

    • Ashley

      Thank you for your response!

  • Dear Petseeker,

    I suggest that you check with your state social services office to see whether you can qualify for Medicaid based on your family income and the fact that you are working, either for months that SSI is suspended or for all months instead of SSI-based eligibility.

    Sincerely,
    Kay

  • Dear Trezario,

    It typically takes a couple months after SSI has been paid for the SSD to start. And, your SSD claim is sitting on someone’s desk waiting its turn to be worked up for payment authorization. SSI will continue until SSD is paid.

    Sincerely,
    Kay

  • Dear Jay,

    SSI is payable for months before Social Security benefits start if your and your husband’s other income and assets are within the SSI limits not considering the Social Security that hasn’t been received yet.

    Social Security Disability (SSDI) back pay is offset (reduced) by SSI back benefits payable for any months that eligibility overlaps. So, it is correct that payment of the SSDI is dependent in part of the status of the SSI claim. If the SSI claim is not payable, the local office is supposed to tell the payment center that no SSI is payable so the SSDI can be processed.

    Your husband needs to contact the local office and if he has not received a formal Supplemental Security Income (SSI) denial, to check to see if his SSI claim is still open. If it is still open, he can either voluntarily withdraw the SSI application or he can pursue payment of the SSI. If the claim is still open, I suggest that he provide all the necessary financial information to receive the SSI because it will get paid faster than the SSDI and because SSI is not taxable whereas some of the Social Security could be taxable based on how much SSDI back pay he gets and on how much other income the family has.

    Sincerely,
    Kay

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